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Why a doula is like a personal trainer for birth

When describing what it is that I do I sometimes use the analogy of a doula as a personal trainer for pregnant women: we are helping you to prepare for an endurance challenge, training you for a marathon, not your weekly parkrun! Just like personal trainers, doulas have likely experienced that challenge before a number of times, either first or second hand. And in just the same way as using a personal trainer, although it’s not essential to use a doula, having one on your team may improve your outcome.


This blog was inspired by a recent physical challenge I undertook and it explores some of the similarities in the process of preparing for a long race and preparing for birth.


Last weekend I completed a half marathon, the Big Half; my first ever half marathon, and the farthest I have ever run in my life. For some it may be ‘only’ a half marathon, but as a person who is not a natural athlete I feel immensely proud of my achievement. I was very nervous beforehand, I did have to walk for parts of it, I didn’t particularly enjoy it at times and I was uncomfortable for several days afterwards, but I did it and have the medal to prove it!!


One of the things about running is it gives you time to think, preparing for and completing an endurance event gave me the space to draw parallels between the preparation and thought processes I went through and those that a woman goes through when preparing for and going through childbirth. Bear with me, there are plenty of ways in which it’s NOT similar, but also some pretty major ones that are!


Build a supportive team

As I mentioned, I was nervous about the half marathon. I joined a local women’s running group, 261Fearless Greenwich, last year and was swept up in the enthusiasm to take part when the group were allocated community places in a new London half marathon. Having a supportive team behind me was paramount in preparing for and completing the half marathon, whether they were running beside me or cheering me on! In childbirth that team may be very small, just you and your partner, or it may be larger, including members of your wider family or a doula, but your team will be with you throughout the whole process, in choosing to take part together, in encouraging you onwards and in celebrating your successes (or evaluating what could have gone better).



Preparation

In the weeks and months leading up to the half marathon I prepared by following an informal training schedule. These training schedules have been used by hundreds of runners, fine tuning them to really help deliver the goal each person wants. My goal was to make sure my body was as fit as I could make it (within the constraints of being a working, middle-aged woman!). In the months before the race, we met on Sundays to trudge the parks and pavements of South East London building up to a distance of 12.6 miles before tapering back down (rather steeper tapering that might have been ideal due to that infamous cold snap, the Beast from the East!)

Similarly, when preparing for birth it is a good idea to prepare your body by being as fit and healthy as you are able to be. Not only will it help you to endure the hours of labour, but also it will help you to regain your figure afterwards.


Education

I wanted to know how best to enjoy, rather than just endure, the process of running for several hours. I looked up sports nutrition and training schedules. I read articles and blogs about how athletes and ‘normal’ people prepare for endurance events. When you are going through a process that others have experienced before you it is wise to take advantage of their knowledge.

I’m not saying that I followed all the suggestions, and I certainly don’t suggest that a pregnant woman tries all the (sometimes rather odd) preparatory measures others have tried, but she should also read around, find out what has worked for people who have been there before. Decide which techniques make sense to you, try some of them and find out whether they work for you or not.


Eat, sleep, run, repeat

I didn’t manage my sleep and fuel in the run-up to the half marathon, and I think my experience suffered for it. If you know you’re going to be doing something physically demanding in the near future it’s a good idea to be as well rested as you can be. Similarly, making sure that you’re following a balanced diet throughout pregnancy is setting you up for a better endurance during labour. Eat during early labour, making sure that you have consumed complex carbohydrates that will release energy over a longer period of time, and during active labour you may wish to consume simple sugars like glucose or sucrose to keep you going. You may even wish to try the gels that athletes use, since they are isotonic (so won’t dehydrate you) and are actually quite palatable (I like the the SiS ones in particular). Equally, it’s important to make sure you stay hydrated with plenty of water.


Positive stories

How you cope with endurance events such as (half) marathons is largely psychological as well as physical. The ability to keep going, even when you are exhausted and in pain, is a matter of mind over body. Sometimes it’s as simple as the person running next to you telling you to keep running!


Clearly in labour there are hormonally controlled processes that take place in your body without the conscious control of your brain, but the ability to keep moving around and to stay positive are mental.

I was nervous, but not terrified, before the half marathon. Reading and listening to other people’s positive stories about going through the same process that I was about to go through helped me to feel that ‘I can do this!’


I conducted a research project last year and one of the key findings was that pregnant women should listen to positive birth stories in the run up to their labour. Women who have enjoyed their experience of childbirth are an important resource and should be encouraged to share their stories rather than being made to feel that they are ‘showing off’ or belittling other’s difficult experiences. If one approaches a process with dread and fear it is less likely to have a successful outcome, particularly one such as childbirth where your mind-set affects the balance of hormones that are driving the process.


Sometimes you poop

Bear with me for this one, it DOES relate! Many women have a fear of pooing during the second, pushing stage of labour. I had a fear of pooing during the race. It does happen, and I have seen athletes with the tell-tale brown streaks down their legs carrying on as if nothing has happened. I had made sure to eat a good breakfast, so it’s no surprise that one I started running and joggling my stomach up and down that I needed to go. Fortunately there were regular comfort stations with portaloos (though the queues and the state of some of the toilets indicated that I wasn’t the only one suffering ‘runner’s tummy’). In the same way, these things sometimes happen during labour. One has to accept it, sort yourself out and carry on. The medical professionals won’t give two hoots, and you should try not to as well!!


So, in conclusion, in both situations you are more likely to look back on your experience in a positive light (and maybe even ~whispers~ enjoy some of it) if you prepare well, educate yourself, listen to positive stories, rest and nourish yourself and don’t worry too much about the possibility of doing a poo!

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